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STATE-OF-THE-ART PAPER

Rimonabant: A Cannabinoid Receptor Type 1 Blocker for Management of Multiple Cardiometabolic Risk Factors

Eli V. Gelfand, MD^_* and Christopher P. Cannon, MD^,a,_*

^_* Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts

Manuscript received November 29, 2005; accepted December 14, 2005.

^_* Reprint requests and correspondence: Dr. Christopher P. Cannon, Cardiovascular Division, Brigham and Women’s Hospital, 75 Francis Street, Boston, Massachusetts 02115 (Email: cpcannon{at}partners.org).

Rimonabant is a first selective blocker of the cannabinoid receptor type 1 (CB₁) being developed for the treatment of multiple cardiometabolic risk factors, including abdominal obesity and smoking. In four large trials, after one year of treatment, rimonabant 20 mg led to greater weight loss and reduction in waist circumference compared with placebo. Therapy with rimonabant is also associated with favorable changes in serum lipid levels and an improvement in glycemic control in prediabetes patients and in type 2 diabetic patients. At the same dose, rimonabant significantly increased cigarette smoking quit rates as compared with placebo. Rimonabant seems to be well tolerated, with a primary side effect of mild nausea. As an agent with a novel mechanism of action, rimonabant has a potential to be a useful adjunct to lifestyle and behavior modification in treatment of multiple cardiometabolic risk factors, including abdominal obesity and smoking.

Abbreviations and Acronyms   BMI = body mass index   CB1 = cannabinoid receptor type 1   HDL = high-density lipoprotein   LDL = low-density lipoprotein   RIO = Rimonabant in Obesity   STRATUS = Studies with Rimonabant and Tobacco Use   THC = tetrahydrocannabinol

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